If you or someone in your family has chronic kidney disease, you probably know that some things that should be removed by the kidneys accumulate in the body. One such thing is "phosphate". This phosphate, which we absorb from the food we eat, is excreted from healthy kidneys in the urine. But when the kidneys function poorly, especially when it comes to dialysis, this phosphate starts to accumulate in the blood. This is not good for the body at all. This can lead to bone weakness, joint pain, skin rashes, and even heart disease over time. That is why your doctor prescribes various medications to control the level of phosphate in the blood. Sevelamer is one such very important medication.
What is Sevelamer? How does it work?
Simply put, Sevelamer is a phosphate magnet. It comes in the form of a pill or capsule. When you take this medicine, it binds to the phosphate in the food you eat in your intestines and stops the body from absorbing that phosphate. Then, the bound phosphate is passed out of your body in your stool. Think of it like a garbage collector, going into your intestines and picking up unwanted phosphate and throwing it out.
The most important thing is that this medicine is not absorbed into the blood. It works only in the digestive system, that is, inside the intestines. That is why this is a very safe medicine. This medicine can come under brand names like RenaGel and Renvela.
Things you need to tell your doctor before taking this medicine
Before prescribing Sevelamer, it is important that your doctor is fully aware of your health condition. Be sure to tell your doctor if you have any of the following conditions:
- Bowel blockage: If you have had a bowel blockage before.
- Constipation: If you have frequent constipation, this medicine may make it worse.
- Swallowing difficulties: If you have difficulty swallowing even pills.
- Other stomach or intestinal diseases: If you have previously had stomach or intestinal surgery, or if you have another medical condition.
- Allergies: If you have an allergy to Sevelamer or any other medicine, food, or dye.
- If you are pregnant or trying to get pregnant.
- If you are a mother who is breastfeeding.
Based on this information, your doctor will decide whether this medicine is right for you or whether the dosage needs to be changed.
How to use Sevelamer correctly?
To get the most out of a medicine, you need to use it properly.
1. Take with food: This is the most important thing. Because this medicine works by binding the phosphate in food. Therefore, it is essential to take this medicine with the main meals (morning, noon, and night) . Taking this without food will not work.
2. Swallow with a glass of water: Swallow the tablet or capsule whole with a glass of water. Do not break, crush, or chew the tablet. Ask your doctor for advice.
3. Take it at the right time: Take the right dose at the right time as prescribed by your doctor. Do not skip a single dose.
4. Don't stop taking it on your own: No matter how well you feel, don't stop taking this medication suddenly without your doctor's advice.
5. Other medications: If you are taking other medications, you may need to take them at different times than Sevelamer, but space them out by an hour or two. This is because Sevelamer can interfere with the absorption of other medications. Therefore, talk to your doctor about all medications you are taking and plan your medication schedule accordingly.
Do you give this to small children?
Yes, in some special cases, this medicine is also prescribed to children over the age of 6. But it is done under the strict supervision of a pediatrician.
What if I take too much medicine or miss a dose?
Overdose: If you suspect that you have taken more medicine than you think, go to the nearest hospital Emergency Treatment Unit (ETU) immediately . Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Missed dose: If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose (e.g., less than two hours), skip the missed dose and take your next dose at the scheduled time. Never take two doses at once to make up for a missed dose.
Other medications and things that may interact with Sevelamer
Sevelamer may interfere with the action of some medications. Therefore, it is important to inform your doctor if you are taking the following medications:
- Antibiotics such as Ciprofloxacin
- Cyclosporine
- Mycophenolate
- Levothyroxine - a medicine for thyroid diseases
- Tacrolimus
This list is not complete. So tell your doctor about any other medications, vitamins, traditional medicines, or herbal products you are taking. Also, tell your doctor if you smoke or drink alcohol.
Possible side effects while taking the medicine
Like all medicines, Sevelamer can cause some side effects, although not everybody gets them. The following are some of the possible side effects.
| Type of side effect | Description and what to do |
|---|---|
| Serious side effects that should be reported to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue, difficulty breathing. |
| Severe constipation | No bowel movements for days, severe stomach pain. |
| Side effects that are usually not dangerous, but should be reported to the doctor if they persist | |
| Stomach ache | Gas, stomach pain, nausea, vomiting, diarrhea. |
If you experience any other unusual symptoms not on this list, talk to your doctor about them as well.
Other things to be careful about while taking the medicine
- Regular medical checkups: Attending the clinics as scheduled by your doctor is essential to see if your condition is improving.
- Blood tests: Your doctor will often order blood tests to check things like your blood phosphate levels and calcium levels. Don't skip them.
- Vitamins and Nutrition: Sevelamer may interfere with the absorption of some vitamins. So talk to your doctor or nutritionist about whether you need additional vitamins. Eating a balanced diet is also important.
- Medicine storage: Keep pills out of the reach of children. Store at room temperature (between 15-30 Celsius), away from moisture and direct sunlight. Throw away expired medicine.
Take-Home Message
- Sevelamer is a very important medication for controlling blood phosphate levels in long-term kidney patients.
- This medicine must be taken with main meals , otherwise it will not be effective.
- Give your doctor a complete description of all other medications, vitamins, and other medical conditions you are taking.
- If you experience symptoms such as severe constipation or allergies, seek medical advice immediately.
- Never stop taking medication or change the dosage without your doctor's advice.
- Attending medical clinics on time and undergoing the necessary blood tests is essential for your well-being.
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